Remote RN Case Manager - Care Transitions - Bilingual Spanish - California RN License Required

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them.

About the role

Responsible for health care management and coordination within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Coordinates and monitors Alignment Healthcare member’s progress and services to ensure consistent cost-effective care that complies with Alignment policy and all state and federal regulations and guidelines. Performs duties mostly telephonically.

Responsibilities

• Create individualized discharge plans with patients, families, and the care team.
• Coordinate care with providers, rehab facilities, and home health agencies.
• Monitor patient progress and adjust plans as needed.
• Educate and empower patients and families for self-care and follow-up.
• Advocate for patient needs and connect them to community support services.
• Participate in care conferences, quality improvement initiatives, and interdisciplinary collaboration.

Requirements

• 5 years of clinical case management experience; or any combination of education and experience, which would provide an equivalent background.
• Active, unrestricted RN license in California (willing to obtain other state licenses).
• Knowledge of Medicare Managed Care Plans, insurance regulations, and community resources.
• Strong communication, problem-solving, and organizational skills.

Benefits

• Fully remote role with flexible scheduling.
• Opportunity to lead impactful patient care initiatives.
• Collaborate with a supportive, interdisciplinary team.
• Professional growth and continuous learning opportunities.

Essential Physical Functions

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to talk or hear.
• The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds.
• Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay

Pay Range: $85,696.00 - $128,543.00. Pay range may be based on a number of factors including market location, education, responsibilities, and experience.